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Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy.
Eur Spine J. 2012 Jun; 21 Suppl 4:S453-7.ES

Abstract

INTRODUCTION

A 47-year-old male with a history of recurrent low-back pain presented with acute left radiculopathy.

MATERIAL AND METHODS

The CT and MR scans showed a severe osteochondrosis of the L4/5 segment, a broad protrusion of the disc annulus and extrusion of nucleus material into the spinal canal on the left side.

RESULTS

The caudally dislocated sequester pieces were visualised intradurally and the intraoperative finding confirmed this rare pathology. After dorsal durotomy-free sequester material was found between the nerve rootlets within the subarachnoid space and altogether ten fragments were removed. Further transdural exploration visualised ventrally a round dura defect surrounded by a thickened arachnoid layer with enlarged veins as a sign of a chronic erosive process.

DISCUSSION

Patients history, imaging and the intraoperative findings support the thesis, that chronic degenerative disc disease and adhesions between the posterior longitudinal ligament and the dura are the predisposing pathogenetic factors for an intradural disc herniation.

CONCLUSION

Intradural disc herniation is a rare condition and requires durotomy to remove the pathology. Therefore an actual high resolution MRI is mandatory in all cases of intraspinal space occupying lesions.

Authors+Show Affiliations

Department of Neurosurgery, Heinrich-Heine University Medical School, Düsseldorf, Germany. floeth@vkkd-kliniken.deNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22109565

Citation

Floeth, Frank, and Jörg Herdmann. "Chronic Dura Erosion and Intradural Lumbar Disc Herniation: CT and MR Imaging and Intraoperative Photographs of a Transdural Sequestrectomy." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 21 Suppl 4, 2012, pp. S453-7.
Floeth F, Herdmann J. Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy. Eur Spine J. 2012;21 Suppl 4:S453-7.
Floeth, F., & Herdmann, J. (2012). Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 21 Suppl 4, S453-7. https://doi.org/10.1007/s00586-011-2073-2
Floeth F, Herdmann J. Chronic Dura Erosion and Intradural Lumbar Disc Herniation: CT and MR Imaging and Intraoperative Photographs of a Transdural Sequestrectomy. Eur Spine J. 2012;21 Suppl 4:S453-7. PubMed PMID: 22109565.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic dura erosion and intradural lumbar disc herniation: CT and MR imaging and intraoperative photographs of a transdural sequestrectomy. AU - Floeth,Frank, AU - Herdmann,Jörg, Y1 - 2011/11/23/ PY - 2011/07/26/received PY - 2011/11/06/accepted PY - 2011/10/19/revised PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/10/26/medline SP - S453 EP - 7 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 21 Suppl 4 N2 - INTRODUCTION: A 47-year-old male with a history of recurrent low-back pain presented with acute left radiculopathy. MATERIAL AND METHODS: The CT and MR scans showed a severe osteochondrosis of the L4/5 segment, a broad protrusion of the disc annulus and extrusion of nucleus material into the spinal canal on the left side. RESULTS: The caudally dislocated sequester pieces were visualised intradurally and the intraoperative finding confirmed this rare pathology. After dorsal durotomy-free sequester material was found between the nerve rootlets within the subarachnoid space and altogether ten fragments were removed. Further transdural exploration visualised ventrally a round dura defect surrounded by a thickened arachnoid layer with enlarged veins as a sign of a chronic erosive process. DISCUSSION: Patients history, imaging and the intraoperative findings support the thesis, that chronic degenerative disc disease and adhesions between the posterior longitudinal ligament and the dura are the predisposing pathogenetic factors for an intradural disc herniation. CONCLUSION: Intradural disc herniation is a rare condition and requires durotomy to remove the pathology. Therefore an actual high resolution MRI is mandatory in all cases of intraspinal space occupying lesions. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/22109565/Chronic_dura_erosion_and_intradural_lumbar_disc_herniation:_CT_and_MR_imaging_and_intraoperative_photographs_of_a_transdural_sequestrectomy_ L2 - https://doi.org/10.1007/s00586-011-2073-2 DB - PRIME DP - Unbound Medicine ER -